I'm a breastfeeding counselor with a side hobby in educating parents and caregivers in proper car seat use. I have four sons, one born by c-section and three born by VBAC. I blog about my life with four kids, pregnancy and birth, breastfeeding, and car seats.

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Friday, January 31, 2014

I've been debating whether to write this down at all, or to write it down but not publish it, or to write it down and then delete it, or just to think about it and then squash down the thoughts. I'm still not sure if it should be out there, but I try to be honest on my blog and with my life, so here it is.

I become very jealous of people when I hear they have a baby girl.

There, I said it.

I love my four boys. I can't imagine life with a daughter. I can't imagine my life being any different than it is. I have four sons, and I don't regret having them, I don't regret having four, I don't regret any of it. I love my sons. I love saying I have four sons. I love saying "my four sons." I like to think I'm raising four boys who will become four wonderful men and marry four wonderful women and provide me with scads of grandchildren, boys and girls. I like to think I'm contributing positively to the next generation of men, a generation of men who are respectful of women, honest about their emotions, not afraid to express love, abhorrent of injustice and violence. I hope that I am raising four intelligent, ambitious, successful human beings who will make the world, or their little corner of it, a better place by the fact of their being in it. (Is that a bit arrogant? Maybe. But isn't that what parents really hope for in their kids? That they are raising people they will be proud of?)

But when I see a friend post a picture of their new baby girl, or a picture of their little girl in a cute dress, or talk about their little girl doing something girly like having a tea party with her dolls or wanting to paint her nails or do her hair...

I admit to being jealous, and a little sad.

I always assumed I'd have a girl. I thought if I had four kids, they'd be two girls and two boys. I thought I'd have a girl first. You want to have a girl first, you see, because then she'll help with her baby siblings. She'll be a little mama.

What I have are four boys. And my oldest boy? He helps so much with his younger brothers. And my boys like getting new clothes, and my second boy once asked to paint his nails, and there was that time four of us sat and had a tea party together (granted, we made gross pretend soup, but still, it was kind of a tea party).

But there was this one time, when I was pregnant with #4 and hadn't found out the gender yet, that I saw a cute little yellow dress at Kohl's in the toddler girls section, and I picked it up and admired it and then put it in my cart and started toward the register, and then laughed and put it back on the rack when I realized what I was doing. But I really was going to buy it, because I was sure I was going to have a daughter.

I was supposed to have a daughter.

I always imagined how I would raise a girl. How I would teach her about life and womanhood, and how I would be clueless about makeup and fashion, and how she would see that you can grow up to be a strong, happy, fulfilled woman even without those things, and how there are lots of ways to feel fulfilled in life. I thought I would be there for her when she was pregnant, and pass along all my knowledge about pregnancy and birth and breastfeeding. Not that I can't do those things for a future daughter-in-law, but it's not the same, in my mind.

I joke about how I'm so relieved not to have a girl, that I don't have to deal with the tween girl hormones or synced up cycles. I laugh and say I'm so glad I don't have to experience the drama of the 4-year-old girl or the terror of the teen years.

I joke, and I smile, and I laugh, but...

I love my sons so much, and I hope that I'm able to teach them all the things that will make them exemplary husbands and fathers, even though I'm not sure I really know how. And I love my sons so much, and one day they'll bring home a woman to the Passover seder or a Shabbat dinner or to Thanksgiving and say, "Mom, I want you to meet my fiancee," and then I can look forward to having a daughter-in-law and granddaughters to bond with.

And I love my sons so much, and four kids is plenty, and I don't think I can do it again, the pregnancy and the birth and the baby years and the toddler years and the diapers and the sleepless nights, even if it meant I would have a daughter. Even then.

So I mourn the daughter I will never have.

And I'm sad for myself when my friends have baby girls.

And I gather my four beautiful sons into my arms and I love them so much and I can't imagine my life any other way.

It's finally here! You've finally reached the end of your pregnancy! You're 38, 39, 40 weeks (or even 41) weeks along. You're anxious to meet your baby. This section will address what's going on with your body at the end of pregnancy and some things to think about as you go into labor.

Nearing and Passing Your Due Date

As described in an earlier article, your "due date" is really just an estimate of when your baby will be born, based on your last menstrual period. A normal, full-term pregnancy can run anywhere from 38 to 43 weeks, and the 40-week estimate is just a convenient mid-point of that range from which to measure the pregnancy. Many factors, both natural and artificial, can influence when you give birth, and scientists and researchers have yet to determine the exact mechanism or sequence of events that tells your body to start the labor process.

By the end of the pregnancy, though, you're likely feeling very uncomfortable. You're big, ponderous, experiencing aches and pains, having difficulty sleeping at night, having heartburn, needing to pee frequently, noticing swelling in your fingers, hands, ankles, and feet; you're short of breath and possibly even feeling strong, if not painful, contractions of the uterus. You're ready for this pregnancy to be over and to start life with your new baby.

Remember that every day that your baby grows inside you is good for his lifelong health. Take things day by day, and remember that you will eventually have this baby!

What Your Body and Baby Are DoingAt the end of your pregnancy, your body and baby are getting ready for labor and delivery. From early in your pregnancy, you were experiencing mild contractions called Braxton Hicks contractions. These contractions help to "warm up" the uterus and strengthen the muscle to eventually push out that baby. As you near the end of your pregnancy, these contractions will increase in frequency and intensity but will generally not be painful.

You may also experience early labor, or prodromal labor, also called "false labor." These are regular contractions that may be mildly to noticeably painful that continue for several hours and then stop without building in frequency or intensity. Prodromal labor may begin several weeks before your estimated due date. Many women call their provider or even go to the hospital thinking they are in labor, only to find out that the cervix is not dilating or that an hour of rest makes the contractions stop. If you experience painful, regular contractions, try lying down and resting for a while, drinking water, or even going for a walk. If the contractions slow down or stop after a while, you were probably experiencing prodromal labor. If they continue to increase in intensity and frequency, there's a good chance you are in the early stages of active labor. It can be very hard to know for sure, even if you've been through childbirth before, so don't be embarrassed to call your provider to find out what you should do.

Your baby should "drop" into the pelvis in the late stages of your pregnancy. This may happen a few weeks before your are due, or it may happen just days or hours before labor begins. You'll notice that the weight of your uterus seems to be lower in your abdomen than it has been, and the shape of your belly may change. You may be able to breathe more easily, and your symptoms of heartburn and pressure in your chest may ease. You will feel more pressure in your pelvis, more urgency to pee, and possibly increased constipation or hemorrhoids.

Your baby is packing on weight at the end of your pregnancy, at a rate of about half a pound a week! Ideally, she is settling into a good position for delivery, with the narrowest part of her head, the occiput, pointing toward your cervix. You can help her along by being upright and active, walking, stretching, and moving your body in ways that feel good. Unless you are on bedrest for health reasons or are experiencing unusual symptoms that make physical activity particularly painful, the end of your pregnancy is not a time to convalesce (that comes after you give birth!).

Going Post-DatesAs you near your estimated due date, your provider may discuss with you how far "post-dates" or "overdue" he or she is comfortable allowing you to remain pregnant, and what to do if labor does not start spontaneously by a certain date. Remember that the average first pregnancy goes beyond 41 weeks, and that the "due date" really is only an estimate. Your provider may express concerns about the health of your placenta or the size of your baby and may request that you have a non-stress test (NST). We talked about NSTs in the previous article.

There are two main issues with a pregnancy continuing on into the 42nd week. You may raise these concerns with your provider, or she will likely bring them up with you if you do go past 40 weeks. The first concern is that your placenta may begin to age or calcify, which would be dangerous for your baby. The health of the placenta can be checked by ultrasound, but as long as your baby's heart rate is good and he is moving normally, you probably don't have a lot to worry about. The other concern is that the baby may "poop" in the womb, or release meconium. The problem with that is that he may aspirate the meconium into his throat or lungs before or during delivery. Meconium is very sticky and can cause breathing problems if inhaled.

Because of the risks associated with these possibilities, some providers are not comfortable with a pregnancy going much more than 10 days "overdue." She or he may offer an induction or ask that you schedule a c-section. Remember that there are many risks associated with an artificial induction of labor and with c-section that are not found in a normal, spontaneous labor. You may like the idea of knowing when your baby will be born, but you should also be aware of these risks.

The biggest risk of an artificial induction of labor is emergency c-section. If the induction of labor does not work, or if your cervix does not dilate fully, and especially if your waters are broken, it may be necessary to get the baby out some other way. Pitocin can cause the baby to go into distress, which would also typically require an emergency c-section. There is also the chance that your due date was incorrectly estimated or that your baby really did need those extra days or weeks to grow and that inducing labor means that he comes too early, leading to lifelong health problems due to his brain or lungs not being fully developed.

Your provider may also mention your baby's size as a reason for wanting to induce. The size of the baby rarely has any bearing on whether it is possible to give birth vaginally. Remember, too, that ultrasound estimates and measurements of your uterus are just guesses that can be off by up to 1.5 to 2 pounds. "Large baby" alone does not have to be a reason for early induction or scheduled c-section.

It is important to investigate the risks of interfering with the natural process of labor before making your decision. Don't be afraid to ask questions of your provider regarding his or her reason for wanting to induce or schedule a c-section and the risks to you and your baby both of waiting for labor to start spontaneously and of induction and c-section.

Many women become impatient to give birth and will look for any trick to get their bodies to go into labor. Some of the "natural" (non-medical) ways you might attempt are:

Sexual intercourse: Having sex releases the hormone oxytocin, which is the same hormone that stimulates uterine contractions. In addition, semen contains prostoglandins, which can help ripen the cervix. Do not have sexual intercourse if your water has broken or if your provider has asked you to refrain from sexual activity for any reason.

Walking: Taking long walks is good for you throughout your pregnancy, and especially at the end. Walking helps the baby get into an optimal position for delivery - head down, with his face to your back - and settles him into the pelvis. The pressure of his head against your cervix as you walk may also help the cervix to begin ripening. If you can manage it, walking up stairs or steep hills can be very effective at moving labor along if you think you're in the early stages, and it's excellent exercise in any case. Otherwise, simply strolling along to music on your iPod or conversation with your partner is good for you. Make sure you stay hydrated, as dehydration can be dangerous for you and your baby during labor. Check with your provider if you are concerned about what level of physical activity is safe for you at these late stages of your pregnancy.

Massage: Stress can inhibit labor, so anything you can do to help you relax is good. Specifically, prenatal massage can also help open up the pelvis and loosen your muscles, as well as relieving pregnancy-related body pains such as back pain.

Nipple stimulation: As with sexual intercourse, stimulating your nipples releases oxytocin, which may trigger uterine contractions. You can self-stimulate, have your partner do it, or use a breast pump for 20 minutes at a time.

Castor oil: Taking a teaspoon of castor oil triggers an "emptying" of your digestive tract (read: possibly painful cramping and diarrhea). It is thought that this may stimulate uterine contractions as well. It is often considered a "last resort" because this effect is uncomfortable and unpleasant.

Various natural/herbal remedies: There are many herbal preparations that you take orally or insert into your vagina that may or may not help jump-start labor as well. Because herbal remedies are not regulated by the FDA, please make sure you are obtaining your preparations from a reputable source and that you are using them according to directions.

Various foods and drinks: I've heard many tales of eating a particular food or drinking something specific that may help bring on labor. Who knows if any of this is true, but it probably doesn't hurt to eat something you like if it has that possibility attached, right?

If your body is not ready to go into labor, or your baby is not quite ready to be born, these methods may not work. However, if you are on the brink, or are in early labor, trying one or more of these options may help to speed things along or get things moving in the right direction. At the very least, it may help you psychologically to know that you are doing something relatively noninvasive to make labor start.

In the previous article, I talked about some of the ways your provider might attempt to get labor started without medications, such as stripping your membranes.

If you are full term (at least 39 weeks, according to the newest recommendations from the American College of Obstetricians and Gynecologists), your provider may offer to have you come in to the hospital for a medical induction. An induction before your body is ready for labor, and especially if this is your first pregnancy, is risky, because your body may simply not respond well to the induction. Many labor inductions result in an emergency or unnecessary c-section that may have been avoided if labor was allowed to start spontaneously. However, if you must be induced for a medical reason (such as preeclampsia), or you elect to be induced because of severe discomfort, a medical induction is fairly straightforward.

Depending on your circumstances, whether there has been any cervical ripening or dilation, and the urgency of the induction, your induction may start with a drug to ripen your cervix, which is inserted into your vagina and left there for 12 to 24 hours. Sometimes this alone can start labor, if you are nearly ready. Alternatively, your provider may use a special device that physically opens the cervix over the course of about 12 hours. Once some cervical ripening has occurred, you will likely be started on a Pitocin IV.

Pitocin is a synthetic version of the hormone oxytocin. Oxytocin is produced in the brain under several different circumstances, such as sex, breastfeeding, and labor. During childbirth, oxytocin specifically stimulates uterine contractions. Synthetic oxytocin - Pitocin - will also stimulate uterine contractions and is administered via IV. Pitocin-induced contractions may be more intense, stronger, and more painful than the contractions your body would naturally experience from the oxytocin your brain produces.

Once labor begins, an induced labor will likely follow a similar, if accelerated, pattern to a spontaneous labor, if all is going well. We'll talk about labor and delivery in Part VI, so stay tuned!

Risks and Benefits of Induction
Let's talk briefly about the risks and benefits of having your labor medically induced.

Benefits:
There are occasions where it may be necessary or preferable to have your baby before labor starts spontaneously:

In cases where the mother's life is at risk due to a pregnancy-related complication such as preeclampsia or PUPPPs, giving birth is often the best option, especially if you are near your due date. Giving birth usually resolves the issue almost immediately, so a medical induction or c-section may be preferable to continuing to risk the mother's health or life by allowing the pregnancy to progress.

In cases where the mother is suffering from a pregnancy-related condition such as hyperemesis, induction at the first viable opportunity (37+ weeks) may be an option to relieve the mother's suffering. If you think you can stick it out for a few more days or another week or two, it is likely better for the baby to do so, assuming the condition is controlled and the mother's health is stable. However, you may discuss with your provider the earliest reasonable date for having the baby if you are unwilling to wait for spontaneous labor.

There are certain conditions of pregnancy in which the health of the baby is actually more endangered by continuing the pregnancy than by inducing labor or doing a c-section. One example of this is cholestasis of pregnancy, in which the risk to the baby increases after 37 weeks.

In cases of general extreme discomfort or gestational diabetes, early induction of labor may be preferable to allowing the pregnancy to continue because of pain or extreme weight gain for the mother or danger to her health. In less clear-cut cases, the risks and benefits must be weighed fully, and you should discuss with your provider the best set of options for you and your baby. Especially in cases of GD, your provider may wish to induce early due to "large baby." These types of inductions often fail and result in emergency c-section, and, as stated above, "large baby" is not, by itself, a good reason for early induction.

Some women and their providers consider the convenience of knowing when the baby will be born to be a benefit of medical induction or scheduled c-section. If you have childcare or job issues, if your provider may be unavailable after a certain date, or if you or your partner need to figure out maternity/paternity leave or there are other schedule complications such as a military deployment or the need for a family member to arrive to help with the birth or other children, scheduling the childbirth may be an attractive option. In this case, when there are no actual health issues to consider, weighing the risks against the convenience of knowing the birth date is very important. Some providers will be more reluctant than others to encourage a scheduled c-section or induction under these circumstances, but it is ultimately your choice to make. You should consider the short- and long-term risks for you and your child of waiting versus artificial induction or scheduled c-section.

Risks:

While there may be risks to waiting for spontaneous labor, typically there are greater risks to an early induction (except in certain cases like some of those described above). There are risks both to mother and baby of using Pitocin to start labor and to giving birth before your body or baby are ready.

The list here is not comprehensive but will give you some things to consider as you weigh your options.

Premature or late preterm delivery. Scheduling an induction for your due date or a few days before your due date may result in a baby who was not quite ready to be born. For example, if your estimated due date was off by even a week (you think you are 39 weeks but you're actually 38), and your pregnancy would have continued another week or two beyond that date (to 41 or 42 weeks), inducing labor at 39 weeks may result in a baby who is actually 3 weeks premature. This is called a late-preterm baby, and late-preterm babies may have lifelong health risks or short-term problems as a result of being born just a little too early. These problems may include learning disabilities, lung and breathing issues, susceptibility to illness, NICU stay, difficulty breastfeeding, developmental delays, and low birth weight.

Postpartum hemorrhage. Pitocin use is associated with postpartum hemorrhage due to the hyperstimulation of the uterus.

Fetal distress in labor. Pitocin contractions are intense and often faster and stronger than natural labor contractions. These intense contractions may compress the umbilical cord or cause other stress to the baby, causing a sharp increase or decrease in fetal heart rate, which may lead to an emergency situation requiring a c-section or other interventions.

Increased need for pain medication in labor. Pitocin-induced contractions may be more painful and intense than natural labor contractions, which may sway a mother who is unsure about using medicinal pain relief options toward opting for them. The most common option is the epidural, which limits your movement during labor and may have other risks associated with it, including a drop in maternal blood pressure, lethargic baby, and slowed labor progress. We'll talk more about epidurals and other pain relief options in the next article.

Increased risk of c-section. If an induction "fails," i.e., labor does not progress or the baby goes into distress, a c-section may be necessary. The risk of c-section is much higher in an induced labor than in a spontaneous one, often due to malpresentation (when the baby is not in an optimal position for delivery) or distress (due to the Pitocin).

The final article in this series will talk about labor itself, what to expect as you go into labor, and the decisions you may be faced with once in labor.

Wednesday, January 22, 2014

Breastfeeding has a subtle but incredible effect on me: It makes me addicted to my baby. I've never thought about it in those terms before, but now that I'm on my third nursling, I actually noticed this pattern. When I'm agitated or upset, the first thing I do is seek out my baby and go cuddle with him, and nurse him if he's willing. It's the first thing I think to do when I'm in need of comfort or help calming myself down, when I want to take a few minutes to relax, or if I'm trying to get my thoughts in order or escape some source of stress: I scoop up the baby and lie down with him in bed.

It's perfectly logical. Nursing releases oxytocin, the bonding hormone that is also responsible for feelings of contentment. In a way, you really could become "addicted" to nursing, because the oxytocin burst is so potent. It's not an obvious thing. In fact, as I said, I didn't even realize that I was actively seeking out an oxytocin hit until a few days ago. I was feeling a bit down, and I actually thought to myself, "I need the baby."

But why the baby in particular? Why not one of my other kids, or my husband, or a friend?

Well, I realized that they are also on the list. My first thought is usually the baby, probably because the physical contact coupled with nursing gives me the most immediate oxytocin response. Plus, the baby won't protest, won't judge me, won't talk back, will let me talk to him about anything, won't have other things he'd rather be doing, and is easily scoop-up-able. Sometimes I do gather up my toddler in a hug and a cheek-to-cheek cuddle, or scootch up beside my 5-year-old on the couch, hip-to-hip, to see what he's up to. Many times, a back rub from my husband will put the world right-side-up again. And, a phone call to a distant friend, while no match for physical contact, is still an option when no one else is around.

But there's something about the baby. His skin is so soft and pleasant to stroke. His face lights up in a smile when he sees me. He wiggles in anticipation when I offer to nurse. It's unconditional acceptance and delight in my presence with no expectations or preconditions, no give-and-take, no time limit. I am his world, and, in return, when I need him to be, he is my world.

Knowing the science behind the feeling doesn't take away the magic. Rather, it just reinforces that we are meant to love our children, to bond with them, to crave them. It creates an imperative to protect them, to nurture them, to want to see them happy. Physical affection is necessary and normal. Hugs and kisses and cuddles are a biological need.

Next time you're feeling down, see what your first instinct is. Do you reach for a cigarette or glass of wine, a chocolate bar or cookie? Or do you look for a loved one to hug? I know what I'd choose.

Although chocolate would run a close second.

So that's it, really. I'm addicted to my baby. And I wouldn't have it any other way.

Friday, January 17, 2014

When I'm out grocery shopping with my four boys (and having four boys requires a lot of grocery shopping!), I get a lot of looks. People mentally count my kids. People watch me go by with my train of ducklings. I sometimes feel like I'm leading an invasion whenever we all go somewhere. My kids are noticeable, with two redheads, a taller-than-average 7-year-old, the 5-year-old's big brown eyes, the 2-year-old's contagious grin. They are not quiet kids, and they are not shy kids.

I admit that I'm "that" mom sometimes. My middle two, for some reason, go nuts in stores. They run up and down the aisles shrieking like banshees. They grab each other, knock each other over, get in other shoppers' way. They touch every single price tag. I can't get the toddler to sit in the cart if he doesn't want to. I can't get the 5-year-old to walk sedately beside the cart no matter how many different ways I frame it.

On the bright side, they don't knock things off shelves or break things, so I've got that going for me.

Thankfully, I live in an area full of very friendly and forgiving people. I get indulgent smiles from grandmotherly ladies. I get wondering comments like, "Wow, four boys?! You've got your hands full!" I get commiseration. I'm grateful for all of it, because we parents of young children often feel that everyone is judging our parenting all the time, and it's nice to know that most of the time, the people watching understand that sometimes little boys just want to run around. (And who could blame them for not wanting to go grocery shopping?)

I hope that I remember those amused glances, those understanding comments, the occasional compliment when my kids are grown. I hope that one day I'm that lovely grandmotherly lady who sees a young mom come in with her brood and tells her she's doing a good job, tries to make her baby smile, and commiserates about the nonstop energy of little boys. I imagine that 30 years from now, I'll be the friendly woman in the grocery store who tells that young mom, "Oh, yes, I had four boys. They're all grown up and married now, and they treat me like a queen."

I want to remember this feeling of overwhelmed-ness, of frustration, of burnout, because one day I want to offer the comforting smile, the gentle joke, and the compliment to that young mom in the store with her four boys (or girls). I want to remember how much a kind word can lift a weary soul. I want to be the one to make the toddler's tears turn to smiles, to joke with the 5-year-old, to make silly faces at the baby, so that sagging mother can finish her shopping. I want to be the one who steps aside with my one loaf of bread and carton of eggs so the mom with the full cart and melting-down 2-year-old can just get finished and get home already.

So thank you to the understanding mothers of grown children who have smiled at me and said hello. Thank you to the kind store employees who are patient with me and my crazy kids. Thank you to the other mothers of small kids who join me in a resigned sigh as we cross paths from aisle to aisle. And thank you to the sweet grandfathers who joke with my little ones and tell me about their grandchildren. You brighten my day so that I, in turn, can one day brighten someone else's.

Tuesday, January 14, 2014

If there's a topic common to all parenting blogs, websites, Facebook pages, and playgroups, it's sleep. Sleep, sleep, sleep. "Does your baby sleep well?" "When did your baby sleep through the night?" "How many times do you feed your baby at night?" "How much sleep are you getting?" "Does your baby sleep in your bed?" Sleep. Always sleep.

Sleep is a necessity, and we feel it when we don't get enough. The whole day is affected by how well we slept the night before, whether or not we have kids. But when our sleep is disrupted because of an external force - the baby - we can become resentful and frustrated, because it feels like something outside of our control. Then the discussions about "sleep training" begin. "How do I get my baby to fall asleep on his own?" "How do I get him to stop waking up at night?" "Is he really hungry at night or just eating out of habit?" "Would a pacifier help? What about a lovey?"

Here's what I know about baby sleep.

1. Sleep patterns are not linear.
We have this idea that babies start out waking every three hours to eat, then decreasing the night wakings over time until they're *poof* sleeping through the night, at which point they will continue to do so. This is really, really not the case. Many full-term, healthy, breastfed newborns will sleep fairly soundly, waking every three to four hours or so to eat, especially when they sleep in close proximity to their mothers. However, at around four months of age, there are some major developmental spurts that cause what we call a "sleep regression." Your baby who was sleeping three to four hours at a time, or even more in some cases, suddenly starts waking every hour or two to eat, fussing, crying, needing to be held or rocked. All the "tricks" you had don't work, and you're exhausted. Things slowly improve, and then, around eight or nine months, it happens again! And again at 13 months. And again at 18 months. While you probably will experience these changes in your baby's sleep habits, you should notice an overall trend, over months and years, toward more acceptable (by adult standards) sleep patterns. Some kids don't sleep through the night until after two years old. Some sleep through the night for a while and then stop. Just because your formerly excellent sleeper is now waking every hour and a half doesn't mean you're doing anything wrong. It just means your baby is growing and experiencing physical and mental growth, learning new skills, erupting teeth, and meeting milestones. And while those years sure seem long when you're in them, one day you will sleep again. I promise.

2. Babies don't need to be taught to sleep on their own.
Sleeping through the night is not a skill that needs to be taught; it's a developmental stage that will be reached when the baby is ready. You have not fallen into some great trap if you don't "teach" your baby to sleep through the night by six months, or a year, or two years. You are not doing your baby a disservice by feeding or comforting him when he wakes at night. You are not reinforcing "bad" habits by shushing, patting, rocking, nursing, feeding, offering a pacifier, or bringing him to your bed when he wakes up at night. You are not creating a future insomniac by assisting your baby in falling back to sleep. There are some methods that may help your baby sleep in longer stretches or cease to wake you up at night, and these range from slow and gradual night-weaning to "extinction" crying. Some of these methods work some of the time for some babies. You may successfully teach your baby to sleep well at night and then find, a few months on, that he starts waking again at night. You haven't done anything wrong if you do "sleep train" and it wears off, and you haven't done anything wrong if you don't "sleep train." And, just because your baby sleeps through the night doesn't mean there's anything wrong with someone else's baby who doesn't.

3. Some babies do need to eat at night, and some don't.
Many pediatricians and sleep experts, especially the "old school" ones, will tell you that a baby older than six months doesn't need to eat at night, developmentally speaking, and that if your eight-month-old baby is still waking to nurse or takes a bottle at night, it's because you're reinforcing a bad habit and not because the baby is genuinely hungry. While some babies will stop waking to eat by six months of age (my oldest stopped waking for a bottle at about 5 months), others will continue to wake up hungry throughout the night long beyond that arbitrary age. A baby needs a given number of calories in a 24-hour period, and while some will take in enough during the daylight hours to sustain them through the night, others will not. If your baby is eating enthusiastically at those 1:00 and 4:00 a.m. wake-ups, then I think it's safe to say she really is hungry at those times. If she sucks a few times and then falls asleep for three hours, she's probably doing what we call "non-nutritive sucking," meaning she's not taking in much milk but just needed a little help soothing herself back to sleep. Increasing daytime feeds (in frequency and/or quantity) may help to decrease nighttime feeds. Remember that, especially in the early weeks and months, those early morning and middle-of-the-night feeds are essential for your milk supply, as prolactin levels are much higher at night.

4. Do what works for you and your baby.
If your baby sleeps the best cuddled up with you, then let your baby sleep cuddled up with you (assuming you're in a safe cosleeping environment, of course). If your baby sleeps the best swaddled in a bassinet in another room, then put your baby to bed swaddled in a bassinet in another room. If you simply cannot function because of how often your baby wakes at night, try a method to get him to sleep in longer stretches, whether that's crying-it-out or cosleeping or something in between. If you are content with your baby's sleep patterns and you can function during the day with the amount of sleep you're getting, don't let someone else's experience make you think you're doing something wrong by leaving things as they are. If you feel there is a medical reason your baby is not sleeping, consult with a doctor. If you feel that your baby is not getting enough sleep for her, see what you can do to help her sleep better. With sleep, as with all things baby, finding what works for you is going to make your parenting journey that much smoother.

Thursday, January 9, 2014

We took a 6-day road trip at the end of December with our four boys, ages 7, 5, 2, and 2 months. We traveled from the Bay Area, California, to Las Vegas via Yosemite and Death Valley, then from Vegas on to our old stomping grounds near San Diego, and from there back home to the Bay Area. It was a great trip, and the boys did very well in the car.

Traveling with a breastfed infant has its challenges, but it is completely possible if you take a few things into account when planning your trip. The first thing to remember is, your drive will take longer than Google Maps claims. Sure, it's 10 hours from San Francisco to Las Vegas if you drive straight through and don't hit traffic, but keep in mind that you'll have to stop every few hours to tend to your baby.

The inconvenient thing about traveling with an exclusively breastfed baby is that you can't feed while driving. With older kids, if they get hungry in the car, you can hand back snacks to them to eat and continue moving. With a baby, you have to stop to nurse. On the other hand, the fact that you'll have to stop to nurse means that you also have to stop to get out and stretch your legs, which is highly recommended on long drives anyway.

The best way to handle breastfeeding on a road trip is to try to feed whenever you stop for another reason, so you can minimize your stops. Or, to look at it another way, every time you stop to feed the baby, also go to the bathroom, grab a bite to eat yourself, or fill up the gas tank.

It's important to put the needs of your baby high on your list. Don't try to push the baby to go longer than she normally would just to get in another half-hour of driving (unless you're looking for a safe place to stop, of course!). This can be harmful for your milk supply as well as causing the baby unnecessary distress. Don't rush her to finish a feed or push her to eat more than she can. Remember that, just as it's necessary for you to get out of the car for a bit, it's not good for her to sit in the car seat for many hours in a row. She needs to change positions, look around, and exercise those muscles. She also needs human contact. Sitting backward in the car seat, she doesn't see you or feel your touch. Keep her in mind as you drive!

On the flip side, some babies like being in the car and will sleep more than usual, causing them to eat less often than they would at home. If this happens, you'll need to protect your milk supply. If you can, bring along a manual pump or even just a bottle you can hand-express into and pump either at stops or even while driving (if you're a passenger, of course!). Remember that a baby who eats less during the day may make up for it by wanting to nurse more at night.

Another option to consider is to drive at night. If the view isn't part of the drive, but rather the drive is just a means to get to your destination, consider doing most of your driving early, early in the morning or late at night, when the baby would normally be sleeping anyway. This way, he can sleep in the car, and you don't have to worry so much if he doesn't eat as much on the drive. If you do this, make sure you're well-rested enough to drive safely, of course.

Do NOT nurse while the car is in motion. It can be tempting to sit next to the baby, unbuckle your seat belt, and lean over the car seat to dangle a boob into the baby's mouth while someone else continues to drive. This is dangerous. If you are in a crash or a sudden stop, your body can act as a projectile directly into the baby's face, crushing him.

I tried a few times to feed him out of the car seat and he refused. In a bout of desperation, I tried this awkward position, and he nursed happily. Sometimes babies make no sense! (Note that the car is stopped in a safe place in this picture!)

Get used to and comfortable with nursing in public if you're taking a drive with your baby. You'll find yourself having to breastfeed at rest stops, vista points, restaurants, and gas stations. I do enjoy nursing in the car (while the car is stopped, of course). I find it's comfortable and relatively private. Allow your baby to take all the time he needs to complete the feeding, and take the time yourself to relax a little and reconnect with your baby.

Friday, January 3, 2014

At the end of December we took a six-day road trip from our home near San Francisco to Las Vegas and San Diego and back home. From home to Las Vegas is about a 10-hour drive, according to Google Maps, and from Las Vegas to San Diego is about 5 hours, and then from San Diego back home is about 8 hours. Those are, of course, optimistic estimates that don't take into account the needs of four kids while on the road!

We left on Tuesday the 24th mid-morning, with the return trip planned for Monday the 30th. Our first unscheduled stop was when N, the 7-year-old, had a sudden bout of car sickness and threw up all over himself. We pulled off at a truck stop to clean him and the car up, instructed him in no uncertain terms that he was to spend some time looking out the window and not down at his tablet the whole drive, helped him change his clothes, and continued on our way. Fortunately, that was the first and last problem with illness we had on the whole trip, which I count as nothing short of miraculous!

We had hotel reservations in Bakersfield, Las Vegas, and Oceanside, the three cities where we expected to sleep. My mom was traveling with us, and we needed rooms for the six of us and her. Our older two boys, N and S, stayed in a room with her, and Baby Y and the two-year-old, G, stayed with us. Since N and S are 7 and 5 and can handle their bedtime routines on their own, it seemed like a great opportunity to give them time with Grandma and away from the babies.

We had planned to drive straight through to Bakersfield, which is almost exactly halfway from our house to Las Vegas, but on the way we noticed as we played with our route options that Yosemite National Park wasn't that far out of our way, if we wanted to take a side trip. We decided to go for it and were not disappointed! Yosemite is indescribably beautiful. There was snow on the ground from a recent snowfall, but it was between 45 and 60 degrees the whole day, depending on our elevation, so it was pleasant to stop by the side of the road frequently and see one incredible vista after another. There are many well-placed turnouts and parking areas where you can stop, get out, and enjoy untainted views.

(Click for larger images)

After a few hours in Yosemite, we continued on our way to Bakersfield. The only problem with traveling in the winter is how early the sun sets. By the time we stopped for dinner at a steakhouse in Selma, California, it was quite dark, even though it was barely 6:00. No longer able to enjoy the scenery, which was fantastic the whole way, the drive became more of a chore, trudging along to Bakersfield in an "are we there yet" kind of mood. We arrived, exhausted, relatively late on Christmas Eve in Bakersfield and were happy to relax in the hotel room.

The next morning, we continued on our way to Las Vegas. Our first surprise was the windmill farm in Tehachapi, California. I remembered a drive as a kid during which we had passed dozens, if not hundreds, of windmills on the desert hills, but I didn't remember where I'd seen them. Apparently, they are along the way from Bakersfield to Las Vegas!

After a stop by the side of the freeway to take pictures of the windmills, we headed on down the road to Vegas. Our next pleasant surprise was that the road went straight through Red Rock Canyon, a California State Park. We stopped by the side of the road there, too, to admire the desert scenery, nurse the baby, and, of course, take some pictures!

For some reason, Baby Y didn't want to nurse in a traditional manner like, say, the cradle hold, but he happily nursed when I contorted myself into this uncomfortable position.

As we continued through the colorful winter desert, we investigated the possibility of detouring through Death Valley, as another spontaneous visit to a national park. It was a couple of hours out of the way, but since Yosemite had been such a success, we figured, why not? The kids were being amazingly good and patient, the baby seemed to be enjoying the ride, and the adults were finding the drive relaxing, beautiful, and, dare I say it?, fun!

Death Valley in winter is only between 70 and 80 degrees Fahrenheit, so it was pleasantly warm but not painfully hot. The air is incredibly dry, though, and everyone was thirsty.

We stopped at a pullout overlooking Panamint Valley, on the way down to sea level and beyond.

We had a picnic lunch at the Furnace Creek Visitors Center, where their "official" thermometer informed us the temperature was 80 degrees. Our car said 75. Warm for December, but chilly for Death Valley!

We drove on through Death Valley and climbed up to Zabriskie Point, where I wore Baby Y in the Moby wrap to give myself some freedom of movement and a couple of free hands.

After Death Valley, we drove straight on to the Nevada border, where a giant (fake) cow welcomed us across the state line. It seemed an appropriate place to stop and nurse the baby.

Near the border is the "Area 51 Alien Center," really a quirky convenience store with lots of Area 51 "memorabilia." It's also attached to a (legal) brothel, so there was some brothel memorabilia as well. A funny and bizarre place to stop for some water and alien-themed souvenirs and photos.

Soon after, the sun set, and our journey into Las Vegas was cloaked in darkness. The kids fell asleep, and the lights of Las Vegas welcomed us quietly. We were staying at the Suncoast Hotel, off the Strip. We had dinner at an amazing Brazilian steakhouse and then settled in for the night.

Our plan the next day was to have brunch with my grandparents, who live in Las Vegas, and then head over to the Hoover Dam. We had brunch, and my grandparents very much enjoyed seeing the kids, whom they hadn't seen in two years. After a trip to the Monterey Bay Aquarium on Thanksgiving weekend, we had decided we needed some way to visually track the three mobile kids when we're in a crowded place. I bought bright orange polo shirts for each of them, and they wore them on this trip. It worked great, and we were easily able to spot and count our three boys in the casinos and out and about. We set off for the Dam, but traffic from Lake Mead on to the Dam entrance was so heavy we decided to leave it for another visit and just go down to Lake Mead instead. This made National Park number 3! Lake Mead was nearly empty of visitors, and we drove down to Calville Bay, where there's a marina. We had a snack and wandered down to the docks, where a bunch of ducks found G fascinating.

Back in Las Vegas, we took them to an arcade at Red Rock Casino (where the orange shirts really came in handy!), had smoothies at the food court, and then met my grandparents for dinner.

We were due to leave for Oceanside, our last stop, the next morning. We again had brunch with my grandparents, then hit the road.

One planned stop between Las Vegas and San Diego was Peggy Sue's 50's Style Diner, in Yermo, California. It's a fun place, with a "Diner-Saur" park in the back where the kids played for a bit.

We also stopped at a rest stop to nurse the baby and use the bathroom. We finally made it to Oceanside around 6 in the evening and met some close friends for dinner. We sent the older two boys to sleep at Grandma's house, and my husband and I took G and Baby Y with us to a hotel to sleep. We spent Saturday and Sunday visiting with old friends, then headed home early Monday morning, with a stopover in LA to visit my aunt. We pretty much drove straight home, with a stop at Starbucks in Castaic, California (the last city as you leave L.A. County and enter the desert), to pee and feed the baby, and the Harris Ranch Inn & Restaurant in Coalinga for a delicious late lunch.

It was a relief to arrive home and sleep in our own beds, but the trip overall was excellent. The kids did very well in the car, and I hope that N and S will remember at least some of the journey. I enjoyed seeing parts of the country I hadn't been to, visiting our old home and seeing good friends, and taking in a range of scenery from the evergreen forests of Yosemite to the surprisingly colorful, sandy Mojave desert, to the lights and energy of Las Vegas.

The whole family in one picture!

Family vacations are a way to reconnect with your kids, see the world through their eyes, and build memories together. What is the most memorable trip you took as a kid? Are you planning to take your kids on an adventure someday? Where do you want to go?

Also, see my companion "Family Road Trip" playlist on my YouTube channel! Subscribe to the channel to see new videos as they're published.

Since we had the new baby, Baby Y, we have started making a lot more videos of my wife breastfeeding. I actually went out and bought an HD camera so we can make high quality videos, as I thought it was great she has something she is so passionate about. Many of those videos feature my wife breasts at different levels of exposure. Some are quite vivid, I know. I take the videos, and I edit many of them. And yes, I do like taking them, as she is, to me, the most amazing thing. I find we have gotten closer since we started doing these together. However, when posting it to YouTube, I go back and forth on my feelings regarding this exposure.

There are days that I am very excited about doing this and about the amount of views that she gets for her videos. And then there are days when I am less excited. Like, when I see comments like, “Can u do one with both tits out”, or, “you haveverey nice breasts”. Yes, I know, her breasts are very nice, I love them very much (so, I am also somehow proud “yeah, I get to hit that”). But it is a little frustrating. If you want to be a jerk off (pun intended) go ahead, but do you need to post about it? Be a man, be ashamed of yourself a little, you know, like you are supposed to. When I see those, I wonder if we should continue posting those videos.

But then, there is the other side that, for me, wins in the end. I feel that since we started putting these videos up, I have gotten a lot more comfortable with her breastfeeding anywhere. I used to get a little uneasy when she would breastfeed in a restaurant, or on the couch in a friend's house, especially when the baby pops off and exposes her for a second. I used to get a bit annoyed: why can’t she keep him attached? But now, it seems so natural to me, that I do not mind at all. This means that doing these videos had made breastfeeding more natural, as it should be, for me.

The other day we had friends in our house, and the wife was breastfeeding her toddler, feeling very comfortable as well. I would like to think that our way of seeing breastfeeding helped that. (Please feel free not to correct me if I am wrong!).

And then, there is the view count, and that comment here or there, from an actual mother who liked the video or found the information helpful. Another mother said that this had helped to learn a new technique, or that she realized breastfeeding in a restaurant, or a public place is completely normal and natural. And those are just great, and I hope a higher view count will bring more of those types of comments and help more people find them who are genuinely interested in learning more about breastfeeding.

Now, I am not saying that breasts are not sexy, or not part of sexual life. Trust me, they still very much are, especially now when there is so much of them. But, there is also another part, a part that does not detract from that or change it: the actual intended use of them. And that does not bother me anymore. So, no, I am not comfortable with the idea of those guys watching the videos, and I would be lying to myself if I said it was surprising. But, I am happy that this might help someone, maybe even a guy, see breastfeeding as natural. Hey, maybe at least some of those guys are actually trying to help their wives, right?

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Thank you to my husband for sharing these very candid thoughts about our YouTube projects. To see Jessica on Babies videos, visit http://www.youtube.com/jessicaonbabies and browse the dozens of videos already available, then subscribe to stay up-to-date as new videos are posted!